Phakic lenses — the solution for high prescriptions
When laser surgery is not the best option — high myopia, a cornea that is too thin, stable keratoconus — the phakic lens is my go-to solution for patients in Paris and the Paris region. I place an ultra-soft lens inside your eye, without touching the cornea. Depending on your profile, I use the EVO Visian ICL (STAAR) or the IPCL (Care Group) — the latter extends the range up to −30 D of myopia and +15 D of hyperopia. A major advantage: the procedure is reversible.
What is a phakic lens?
A phakic lens (ICL — Implantable Collamer Lens, or IPCL — Implantable Phakic Contact Lens) is an intraocular lens that I place between your iris and your natural lens, in the posterior chamber of the eye. Unlike cataract surgery, your natural lens is kept: a corrective lens is simply added to complete the eye's focusing power.
The procedure takes 20 minutes per eye, under general anesthesia or local anesthesia with sedation, depending on each patient. I make a 3 mm peripheral micro-incision and insert the folded lens, which unfolds; I then position it in the right place. The procedure is precise, painless and reversible: if needed, the lens can be removed through surgery similar to the implantation, without structural damage to the cornea. Both eyes are operated on the same day.
EVO+ Visian ICL — one of the benchmark phakic lenses in France. The EVO+ Visian ICL (STAAR Surgical) is one of the two phakic lenses approved in France. It is made of Collamer, a collagen-based biocompatible material that is well tolerated by the eye. More than 2 million lenses have been implanted worldwide, with nearly 30 years of clinical follow-up (first European CE marking in 1997).
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The phakic lens step by step
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Who is a candidate for a phakic lens?
The phakic lens is my preferred solution when laser surgery is not indicated: high refractive errors, a cornea that is too thin, stable keratoconus, or simply a preference for a reversible technique that leaves the cornea fully intact. For a first idea of the criteria I assess, you can read my article “Am I eligible for refractive surgery?”.
- You are between 18 and 55 years old (beyond that age, lens surgery may be considered)
- High myopia: up to −30 diopters
- High hyperopia: up to +15 diopters
- Astigmatism, alone or combined (toric ICL available)
- Cornea too thin for laser surgery
- Stable keratoconus
- You want to keep your natural lens and retain a reversible option
- You have uncontrolled dry eye affecting the cornea (laser surgery is contraindicated)
- Insufficient anterior chamber depth (< 2.8 mm)
- Corneal diameter not suited to any available lens
- Early cataract (refractive lens exchange is preferable)
- Uncontrolled glaucoma
- Fragile corneal endothelium (low cell count)
- Active intraocular inflammatory disease
- You are pregnant or breastfeeding
Over the age of 55 or in case of early cataract, refractive lens exchange with an EDOF or multifocal intraocular lens is often a better option — we will discuss it together.
Advantages and points to consider
- A very wide correction range: myopia up to −30 D, hyperopia up to +15 D
- Cornea fully preserved — no reshaping, no weakening
- Fully reversible procedure (the lens can be removed at any time)
- Good optical quality of vision; halos at night are possible, especially early in recovery
- Ideal when laser surgery is contraindicated (thin cornea, dry eye, keratoconus)
- The corneal surface is preserved, without the dry eye risk associated with laser techniques
- Intraocular surgery — the risk of infection is very low but real
- Higher cost than laser surgery (custom-made lens)
- Yearly follow-up required (endothelial health, lens position)
- Like any refractive surgery, it does not prevent presbyopia or cataract later in life
From your first assessment to visual freedom
Dedicated ICL assessment
During the assessment, I perform measurements specific to phakic lenses: anterior chamber depth (OCT), corneal diameter (WTW), endothelial cell count, biometry and corneal mapping (Anterion). These measurements confirm your eligibility and allow me to order a lens precisely matched to your eye.
Preparation
The lens is custom-made to order (3 to 4 weeks' lead time). For hyperopic patients, I perform a YAG laser iridotomy a few days before surgery (a quick, painless in-office procedure): unlike EVO+ myopic lenses, which have a central port that allows aqueous humor to flow, hyperopic lenses require this small preventive opening in the iris to avoid any rise in eye pressure. Myopic patients do not need it. I give you a detailed quote, the informed consent form and prescriptions for your post-operative eye drops.
The day of surgery
The procedure takes 20 minutes per eye, as an outpatient, under general anesthesia or local anesthesia with sedation. You go home 2 hours later, ideally accompanied by someone.
Post-operative follow-up
I see you again at day 1, day 7 and month 1 after each eye. You will use anti-inflammatory eye drops for two to three weeks. Lifelong yearly follow-up is then recommended to check the lens position and the health of your corneal endothelium.
What happens after phakic lens surgery?
Both eyes are operated on the same day. Recovery is quick, but follow-up is lifelong.
Surgery
Blurred vision for the first few hours (due to the dilating drops). No pain, just a slight feeling of pressure. Quiet rest. First use of the prescribed eye drops.
First check-up
I see you again in clinic. Vision is already clearly improved — often dramatically so for high refractive errors. You can resume driving short distances.
Second check-up
Full binocular vision. Return to normal activities.
Full return to activities
You can resume almost all of your activities. Light exercise is possible. Continue to avoid swimming.
Stabilization check-up
I check the lens position, your intraocular pressure and the health of your corneal endothelium. Gradual return to sports, generally with no lasting restrictions beyond the first month.
Lifelong follow-up
A yearly consultation is recommended to check the lens position and the endothelial cell count. This is the trade-off for a technique that fully preserves your cornea.
Comparing the techniques
Each technique has its own indications and limits. Here is a brief comparison to guide you — the final decision is made after your personalized assessment.
| LASIK | SMILE | PRK | Phakic lens (ICL/IPCL) | |
|---|---|---|---|---|
| Corneal procedure | Flap + reshaping | Lenticule extraction | Surface (no flap) | None |
| Visual recovery | 24 h | 24-48 h | 5-7 days | 24-48 h |
| Myopia up to | −10 D | −10 D | −6 D | −30 D ¹ |
| Hyperopia up to | +5 D | +5 D | +4 D | +15 D ¹ |
| Astigmatism | Yes | Yes | Possible | Yes |
| Thin cornea | Contraindicated | Contraindicated | Possible | Ideal |
| Contact sports | After 4 weeks | After 2 weeks | After 2 weeks | After 3-4 weeks |
| Reversible | No | No | No | Yes |
| Anesthesia | Eye drops | Eye drops | Eye drops | General or local |
¹ Corrections beyond −18 D (myopia) or +10 D (hyperopia) require the IPCL (Care Group). The EVO Visian ICL (STAAR) covers myopia up to −18 D and hyperopia up to +10 D.
Fees for ICL / IPCL phakic lenses
ICL / IPCL: €5,500 for both eyes — this package includes the custom-made lenses, the surgery, post-operative check-ups and any enhancement needed within the first year. For your information: these are unregulated fees, not reimbursed by the French national health insurance (Assurance Maladie); some complementary health insurance plans (mutuelles) contribute depending on your policy. You will always receive a detailed quote before making any decision, and payment in installments may be offered — ask about it during your consultation.
Phakic lens FAQ
Your ICL assessment starts here
A complete assessment allows me to confirm your eligibility for a phakic lens, measure your eye precisely and order the lens suited to your case.
Explore the alternatives
If this technique is not right for you, other options may be perfectly suitable.